This is a hidden page (doesn't link to from any of our webpages) for the testing of our CEU Course Application form. - Linda Green

Application to be an Approved Provider for a
Continuing Education Course

Physical Therapy CEUs

Per Sections 1399.92, 1399.95, and 1399.96 of Title 16 of the California Code of Regulations

Section 1: Provider Information
Contact Person:(Required)
Address:(Required)
Will the provider provide services to all licensees without unlawful discrimination (§ 1399.96 (i))?(Required)
Does the provider have a procedure to respond to complaints (§ 1399.96 (h))?(Required)

Section 2: Course Information
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Upload Supplemental Form Section 3 Course Details

Upload Supplemental Form Section 3 Course Details
Please click this link to download the document to be completed and uploaded: Supplemental Form Section 3 Course Details.
Max. file size: 50 MB.
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Upload Supplemental Application Documents

Upload Supplemental Application Documents
Upload Supplemental Form Section 3 Course Details
Drop files here or
Max. file size: 50 MB.
    Upload a file for each instructor. Multiple files can be uploaded.
    Drop files here or
    Max. file size: 50 MB.
      Upload a file for each course. Multiple files can be uploaded.
      Drop files here or
      Max. file size: 50 MB.
        Upload a file for each lab assistant. Multiple files can be uploaded.
        Max. file size: 50 MB.
        Upload an example of the course evaluation to be used for the course(s). Only one file can be uploaded.
        Max. file size: 50 MB.
        Upload an example of the course completion CEU certificate. Only one file can be uploaded.
        Max. file size: 50 MB.
        Upload an example of the course advertisement to be used for the course(s). Only one file can be uploaded.

        Thank you for completing this application. It will be reviewed by the CEU Application approval team and you will be notified in 1-2 weeks.
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